Near-Universal Health Coverage System Would Allow Individuals To Purchase Insurance Through Private Plans

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A national health insurance"connector" program that allows individuals and small businesses tobuy public and private health coverage could provide insurance for up to 44million uninsured U.S.residents, according to an article by the Commonwealth Fund published in the May/June issue of the journalHealth Affairs, CQ HealthBeat reports.

Under the proposal, the government-operated connector authority would offerlower-cost health plans, including a "Medicare Extra" plan built onthe existing Medicare system (Nylen, CQ HealthBeat, 5/13). Allemployers would be required to provide coverage for workers or contribute up to7% of their payrolls into a fund to generate about $45 billion (Dixon, Reuters, 5/13). Tax credits would be used to ensurethat premiums account for no more than 5% of income for lower-income familiesand 10% for higher-income families. People who remained uninsured wouldautomatically be enrolled in a plan when their taxes are filed.

According to a Commonwealth Fund release, if the plan is adopted, the number ofuninsured U.S.residents could be reduced from 48.3 million people in 2008 to four millionpeople in the first year the plan is implemented. The article estimates that asmany as 60 million people would enroll in coverage offered through theconnector program.

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Cathy Schoen, lead authorof the article and senior vice president of the Commonwealth Fund, said,"This approach will eliminate wasteful administrative costs, enable peopleto keep their coverage if jobs or circumstances change, and provide affordablehealth insurance with good access to health care and financial protection forall." She estimated that the plan could save $1.6 trillion over 10 yearsif implemented in combination with new health information technology andnegotiated prescription drug prices. The proposal would require about $15billion in new spending, with the rest offset by reduced administrative costs (CQHealthBeat, 5/13).

Commonwealth Fund President Karen Davis said, "Each of these featurescertainly has elements that will give pause to some groups," but "Ithink the basic bottom line is that if everyone will give a little, it meansyou can get universal coverage." According to Davis, those who would experience increasedcosts as a result of the plan include employers not currently offeringcoverage, health care providers not treating beneficiaries of current publichealth programs and companies selling individual health plans (Reuters,5/13).

Dallas Salisbury, president of the Employee BenefitResearch Institute,said businesses likely would support some of the article's proposals, includingmaintaining current tax exemptions for employer-sponsored coverage."There's a consensus that an employer-based system should continue to bepart of [the] overall approach," he said, adding that employers "wantto continue to be part of the system" (CQ HealthBeat, 5/13).

The May/June issue of HealthAffairsincludes a number of articles that focus on prospects for health care reform inthe current election cycle. The issue contains articles and perspectives bypolitical pollsters, scholars and lawmakers, who examine the political climatesurrounding health insurance, proposals for overhauling the health care systemand past attempts at instituting a national health insurance program. Thejournal also includes articles that discuss important elements to be consideredwhen evaluating health care proposals (Health Affairs release,5/13).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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